CAJ | 학술논문

目的应用实时三维超声心动图(RT-3DE)定量评价不同时期左室心尖球形综合征(LVABS)患者左室收缩不同步性及与左室整体射血分数的相关性.方法 LVABS患者7例,于入院时(入院第1～3 d)、4周末、8周末应用RT-3DE采集左室实时三维全容积数据库图像,启动“4D LV Volume Tom-Tec”软件,测量左室射血分数(LVEF),并获取左室16节段时间-容积曲线,得到各节段达最小收缩容积的时间(Tmsv),分别计算出16节段、基底段、中间段、心尖段Tmsv的标准差和最大差值(Tmsv16-SD/Dif、Tmsv-basal-SD/Dif、Tmsv mid-SD/Dif、Tmsv-apical-SD/Dif),并对左室收缩不同步指数(SDI)与LVEF进行相关性分析.结果 ①与入院时相比,4周末、8周末Tmsv16-SD/Dif、Tmsv-basal-SD/Dif、Tmsv-mid SD/Dif、Tmsv-apical-SD/Dif逐渐降低,差异均具有统计学意义(P＜0.05).②SDI越高,LVEF越低;SDI下降,LVEF升高;SDI与LVEF具有良好的负相关性(入院时、4周末、8周末r分别为-0.758、-0.831、-0.889,均P＜0.05).结论 LVABS患者入院时存在严重的左室收缩不同步,4周末、8周末收缩不同步指数逐渐下降,SDI与LVEF呈负相关.
목적 응용실시삼유초성심동도(RT-3DE)정량평개불동시기좌실심첨구형종합정(LVABS)환자좌실수축불동보성급여좌실정체사혈분수적상관성.방법 LVABS환자7례,우입원시(입원제1～3 d)、4주말、8주말응용RT-3DE채집좌실실시삼유전용적수거고도상,계동“4D LV Volume Tom-Tec”연건,측량좌실사혈분수(LVEF),병획취좌실16절단시간-용적곡선,득도각절단체최소수축용적적시간(Tmsv),분별계산출16절단、기저단、중간단、심첨단Tmsv적표준차화최대차치(Tmsv16-SD/Dif、Tmsv-basal-SD/Dif、Tmsv mid-SD/Dif、Tmsv-apical-SD/Dif),병대좌실수축불동보지수(SDI)여LVEF진행상관성분석.결과 ①여입원시상비,4주말、8주말Tmsv16-SD/Dif、Tmsv-basal-SD/Dif、Tmsv-mid SD/Dif、Tmsv-apical-SD/Dif축점강저,차이균구유통계학의의(P＜0.05).②SDI월고,LVEF월저;SDI하강,LVEF승고;SDI여LVEF구유량호적부상관성(입원시、4주말、8주말r분별위-0.758、-0.831、-0.889,균P＜0.05).결론 LVABS환자입원시존재엄중적좌실수축불동보,4주말、8주말수축불동보지수축점하강,SDI여LVEF정부상관.
Objective To evaluate the left ventricular systolic dyssynchrony in patients with left ventricular apical ballooning syndrome (LVABS) quantitatively by real-time three-dimensional echocardiography(RT-3DE) and its correlation with left ventricular ejection fraction(LVEF).Methods 7patients with LVABS were enrolled in this study.The images of left ventricle in full volume mode were obtained by RT-3DE in the different time (just after admission,4 weeks and 8 weeks).Post-processing software of 4D LV Volume Tom-Tec was used for calculation of EF and 16-segmental time-volume curves was obtained.The time to the point with minimal systolic volume(Tmsv) of each segment was calculated and by which the following indexes of systolic dyssynchrony were derived:Tmsv16-SD/Dif,Tmsv-basalSD/Dif,Tmsv-mid-SD/Dif and Tmsv-apical-SD/Dif.The correlation between systolic dyssynchrony index (SDI) and LVEF was analysed.Results ① The Tmsv16-SD/Dif,Tmsv-basal-SD/Dif,Tmsv-mid-SD/Dif and Tmsv apical-SD/Dif of left ventricle in the patients of 4 weeks and 8 weeks were smaller than those of the patients just after admission.There were significant differences among them(all P ＜0.05).②The more SDI increased,the more LVEF decreased,and vice versa.SDI was negatively associated with LVEF in the different time of admission (just after admission:r =-0.758; 4 weeks:r =-0.831 ; 8 weeks:r =-0.889;all P ＜0.05).Conclusions Left ventricular systolic dyssynchrony of severe degree is observed in patients with LVABS just after admission.But the condition of dyssynchrony has been improved gradually after 4 weeks and 8 weeks.SDI is negatively correlated with LVEF.